Cognitive Reserve and Driving-Related Cognitive Abilities in a Sample of Oldest Old Drivers Undergoing Assessment of Fitness to Drive

Understanding Elderly Drivers' Perception of Advanced Driver Assistance Systems: A Systematic Review of Perceived Risks, Trust, Ease of Use, and Usefulness

BACKGROUND

Elderly drivers often face safety challenges due to age-related declines in cognitive, sensory, and motor functions. Advanced Driver Assistance Systems (ADAS) offer a potential solution by enhancing safety and mobility.

OBJECTIVES AND METHOD

This systematic review investigates the factors influencing the perception and usage of ADAS among elderly drivers, focusing on perceived safety, usefulness, trust, and ease of use.

RESULTS

Older adults show a preference for Level 1 ADAS, which they perceive as safer. Although they acknowledge the usefulness of ADAS in supporting their autonomy, skepticism remains regarding higher-level systems, primarily due to concerns about reliability and invasiveness. Trust and ease of use are essential factors influencing their acceptance. The review identifies common themes and barriers to the adoption of these technologies and emphasizes the need for senior-friendly interfaces and targeted training. The findings indicate that addressing these issues can significantly improve the safety and mobility of elderly drivers. The successful adoption of ADAS among older adults depends on balancing safety, control, and ease of use, with gradual and supportive integration fostering greater acceptance and trust.

CONCLUSIONS

This study outlines practical implications for stakeholders, emphasizing the need for user-friendly ADAS design, public awareness campaigns, government incentives, insurance discounts, and community training to enhance adoption among older drivers.

Effect of Fitness-To-Drive and Metacognition on Road Traffic Injury Among Older Taxi Drivers: Hierarchical Modeling

Age-related cognitive and somatic motor skills changes have been linked to impaired driving abilities. Taxi drivers play an important role in providing public transportation services and security. This study aimed to examine the level of fitness-to-drive (FTD) and identify the predictors of self-reported traffic injury among the older taxi drivers. Taxi drivers 60 years and older in Bangkok and the metropolitan area were enrolled. Hierarchical regression models were carried out to examine the effects of demographics, FTD, and metacognition towards self-reported road traffic injury. Totally, 46.1% of the respondents were classified as at-risk drivers. Drivers with alcohol consumption and low risk perception toward road safety were more likely to experience road traffic injury. Regular assessment of physical and psychometric capacity among older taxi drivers could provide another empirical basis to improve public safety transport.

Evaluation of Psychophysical Fitness in Drivers over 65 Years of Age

BACKGROUND

The deterioration of cognitive and psychophysical ability associated with aging has an effect on road safety, especially in the driving of vehicles. The current study's main objective is to evaluate the psychophysical aptitudes in drivers over 65 years of age in a sample of drivers in Spain.

METHODS

The sample was formed of a total of 1663 drivers who attended a Driver Recognition Center. The evaluation of their psychophysical aptitudes was carried out following the Medical-Psychological Exploration Protocol for Driver Recognition Centers, edited by the Ministry of Health and the General Directorate of Traffic.

RESULTS

The results show increased restrictions in the evaluation of driving ability with age, which are especially significant after 75 years of age. Regarding sex, 70.1% of women have an approved evaluation, compared to men aged between 65-69, although from 69 onwards, the percentage of approved women decreases significantly. The loss of visual capabilities and poor performance in psycho-technical tests are the main causes associated with an evaluation with restrictions, with the number of restrictive conditions increasing with age.

CONCLUSIONS

There is an increase in the number of cases with age-related restrictions, especially in the case of women and ophthalmologic-related problems, although the majority of drivers over 65 years old continue driving, thus continuing with a practice that has been related to the well-being and quality of life of older adults.

The relationship between cognitive reserve and the spontaneous use of emotion regulation strategies in older adults: a cross-sectional study

BACKGROUND

Several studies reported cognitive reserve (CR) as an important factor in promoting healthy aging within a non-clinical aging population.

AIMS

The main goal of the present study is to investigate the link between higher levels of CR and more effective emotion regulation. In more detail, we examine the association between a number of CR proxies and the habitual use of two emotion regulation strategies, cognitive reappraisal and emotional suppression.

METHODS

Three hundred and ten older adults aged between 60 and 75 (mean = 64.45, SD = 4.37; 69.4% female) joined this cross-sectional study by filling out self-report measures of CR and emotion regulation.² RESULTS: Reappraisal and suppression use were correlated. Practicing different leisure activities constantly over many years, being more original and having a higher education promoted more frequent use of cognitive reappraisal. These CR proxies were also significantly related to suppression use, even though the percentage of variance explained was lower.

DISCUSSION AND CONCLUSIONS

Exploring the role played by the cognitive reserve on different emotion regulation techniques can be useful in understanding which variables predict the use of antecedent-focused (reappraisal) or response-focused (suppression) emotion regulation strategies in aging individuals.

Cognitive and brain reserve predict decline in adverse driving behaviors among cognitively normal older adults

Daily driving is a multi-faceted, real-world, behavioral measure of cognitive functioning requiring multiple cognitive domains working synergistically to complete this instrumental activity of daily living. As the global population of older adult continues to grow, motor vehicle crashes become more frequent among this demographic. Cognitive reserve (CR) is the brain's adaptability or functional robustness despite damage, while brain reserve (BR) refers the structural, neuroanatomical resources. This study examined whether CR and BR predicted changes in adverse driving behaviors in cognitively normal older adults. Cognitively normal older adults (Clinical Dementia Rating 0) were enrolled from longitudinal studies at the Knight Alzheimer's Disease Research Center at Washington University. Participants (n = 186) were ≥65 years of age, required to have Magnetic Resonance Imaging (MRI) data, neuropsychological testing data, and at least one full year of naturalistic driving data prior to the beginning of COVID-19 lockdown in the United States (March 2020) as measured by Driving Real World In-vehicle Evaluation System (DRIVES). Findings suggest numerous changes in driving behaviors over time were predicted by increased hippocampal and whole brain atrophy, as well as lower CR scores as proxied by the Wide Range Achievement Test 4. These changes indicate that those with lower BR and CR are more likely to reduce their driving exposure and limit trips as they age and may be more likely to avoid highways where speeding and aggressive maneuvers frequently occur.

Driving-Related Cognitive Abilities: Evaluating Change over Time in a Sample of Older Adults Undergoing an Assessment Regarding Fitness to Drive

Advancing age can bring a decline in many driving-related cognitive abilities. For this reason, public safety concern has raised about older adults' driving performance, and many countries have adopted screening polices to assess older drivers' fitness to drive. As a result of such assessments, authorities may impose behavioral restrictions to driving. The present study examines whether driving-related cognitive abilities change over time and compares drivers either restricted or not by licensing authorities after the first assessment. The data were derived from a database provided by a service of psychodiagnostic assessment of fitness to drive. This database contained data of people referred for cognitive assessment in order to renew their driving license over the period of 2016 to 2022. The sample included 58 cognitively healthy old drivers (mean age = 82.79, SD = 6.13; 97% men) with a follow-up examination (T2) after a period ranging from one to four years (M = 1.59, SD = 0.72) since the first assessment. Cognitive assessments were conducted using the standard test battery from the Vienna Test System (VTS8; ©Schuhfried GmbH, Mödling, Austria). Decision time variability, motor time, reaction time under stress, and obtaining an overview did not show significant changes between T1 and T2, whereas selective attention and inductive reasoning significantly decreased over time in both groups. Improvements in processing speed consistent with practice effects emerged at T2. Restricted drivers (n = 41) maintained significantly worse performances than unrestricted drivers (n = 17) in the follow-up assessment. Chronological age was associated with higher reaction time under stress, while education showed a buffering role against a decrease in perceptual speed. Overall, although older drivers' driving-related cognitive abilities remain relatively stable over the short-term, the decline in some cognitive functions deserves reevaluation and monitoring.

Factors Associated With Driving Status Among Brazilian Older Adults

This study analyzed the factors associated with driving status among older adults in Brazil. The sample consisted of 15,221 older adults (≥65 years) residing in Brazilian capitals in 2018. The following question established the participants' driving status: "Do you drive a car, motorcycle, and/or another vehicle?" Sociodemographic, health conditions, and health-related behaviors were derived through standard procedures. Poisson regression analysis was performed to estimate prevalence ratios and 95% confidence interval. The prevalence of drivers was 28.83%. We found that being physically active during leisure time and higher daily recreational screen time (>3 h/day) were associated with driving status. Self-perceived negative health and being physically active by commuting showed an inverse association with driving status. The high prevalence of older drivers and the characteristics associated with driving reinforces the importance of public policy strategies for these individuals.